Healthcare isnt just changing. Its growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And thats what fueled these exciting new opportunities.
Who are we? Optum360. Were a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, well leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.
If youre looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. Its an opportunity to do your lifes best work.
As a Business Office Specialist with Optum360, you will work with your team members to help identify and resolve issues and serve as a resource for day - to - day operations. Your primary role will be to contact and consult with patients and / or their families who have outstanding medical bills. While ensuring that payment is received for these bills is important, you will also need to provide assistance and support to these individuals as they may be dealing with a medical or financial crisis.
Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers to help identify and resolve issues
Handle escalated and complex customer issues, helping to provide resolution and settlement of account
Contacts customers through a variety of methods (email, form letters and phone calls) to discuss, negotiate payment and resolve outstanding medical bill accounts and balances
Obtains agreement, after discussion with customer, on potential balance payoff and / or payment terms within stated level of authority and guideline limits
Performs research and documents on various computer systems customer information regarding current status, payment expectations, notes of conversations and other relevant information
Prepares and submits reports to internal management on status of outstanding medical bills and proposed / planned payment settlement details
May in some instances transfer settlement of account and related information to external collection agencies and remains in contact with them regarding further payment activity
Reviews, documents, and analyzes all findings for payments, recoupments, and denials
Understands and articulates the client appeal rights with both government auditing programs
Maintains strict adherence to appeal requirements and associated timeframes
Adherence to timely completion of all assigned tasks within appeal software
Maintain communication with payers, both government and non - government, and provide follow - up activity as necessitated to secure information regarding payment, re - coupments, denials, and clarification of correspondence
Provide reconciliation findings and escalate any trends or items of concern
Maintains database information relative to financial activity
Other duties as assigned by the Recovery Audit Supervisor, or designated Audit and
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.